Healthcare Provider Details

I. General information

NPI: 1225299811
Provider Name (Legal Business Name): SUSAN BARBAROSSA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 01/27/2023
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 W PITTSBURGH ST
GREENSBURG PA
15601-2239
US

IV. Provider business mailing address

960 BAKER RD
BRIDGEVILLE PA
15017-1093
US

V. Phone/Fax

Practice location:
  • Phone: 724-832-4000
  • Fax:
Mailing address:
  • Phone: 412-578-5306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberVP001919J
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: